Gut Liver.  2016 Nov;10(6):902-909. 10.5009/gnl15340.

Helicobacter pylori Infection with Atrophic Gastritis Is an Independent Risk Factor for Advanced Colonic Neoplasm

• Lee JY
• Park HW
• Choi JY
• Lee JS
• Koo JE
• Chung EJ
• Chang HS
• Choe J
• Yang DH
• Myung SJ
• Jung HY
• Yang SK
• Byeon JS

• KMID: 2412095
• DOI: http://doi.org/10.5009/gnl15340

Abstract

BACKGROUND/AIMS
Helicobacter pylori is a major risk factor for atrophic gastritis (AG) and gastric cancer. The correlation between H. pylori, AG and colorectal neoplasm (CRN) has only been examined in a limited number of studies, and findings have been inconclusive. We aimed to investigate the association between H. pylori infection status, AG and advanced CRN.
METHODS
This cross-sectional study investigated the relationship between the presence of serum anti-H. pylori IgG antibodies, AG, and advanced CRN in 6,351 consecutive asymptomatic subjects who underwent a screening colonoscopy.
RESULTS
A total of 316 participants (5.0%) had advanced CRN. H. pylori seropositivity was 61.3%. In a univariate analysis, the presence of H. pylori infection was associated with advanced CRN (odds ratio [OR], 1.49; 95% confidence interval [CI], 1.17 to 1.91; p=0.001). H. pylori infection was associated with an increased risk of advanced CRN after adjusting for clinically relevant confounders (OR, 1.34; 95% CI, 1.04 to 1.72; p=0.023). H. pylori-related AG was significantly associated with the risk of advanced CRN (OR, 1.40; 95% CI, 1.03 to 1.91; p=0.030), whereas H. pylori infection without AG was not.
CONCLUSIONS
H. pylori infection increased the risk of advanced CRN, especially when it was combined with AG. Strict colonoscopy screening and surveillance may be warranted in those with H. pylori-positive AG.

Keyword

Helicobacter pylori; Gastritis; Atrophy; Neoplasms

MeSH Terms

Aged
Antibodies, Bacterial/blood
Colonic Neoplasms/diagnosis/*microbiology
Colonoscopy/methods
Cross-Sectional Studies
Female
Gastritis, Atrophic/blood/*complications/microbiology
*Helicobacter Infections/blood/microbiology
*Helicobacter pylori/immunology
Humans
Immunoglobulin G/immunology
Male
Middle Aged
Odds Ratio
Risk Factors
Sentinel Surveillance
Antibodies, Bacterial
Immunoglobulin G